Who Pays for Long Term Care Services?


Long term care can be home care, hospice, assisted living, nursing homes, etc. These services and facilities are designed to assist individuals with both short term needs related to recovering from an illness or injury as well as providing long term care.. How are these services paid for? We put together a few options to help guide the process.

Long Term Care (LTC) Insurance

According to a study from the National Center on Caregiving, 70% of adults 65+ will need long term care. Purchasing LTC insurance is a one way to prepare for these future needs. The younger and healthier you are when it’s bought, the less it costs. If you wait until you need it, your condition may be too advanced to qualify for the insurance any longer. Health coverage offered by employers will not cover extended care. Medicare will cover short term stays in medical facilities such as nursing homes, but to prepare for day-to-day cares, long term care insurance is the best way to ensure you’ll be getting the quality assistance you need when you need it most.

Because you don’t know what challenges are ahead, most LTC providers offer generalized, flexible plans so that you’re covered under a blanket of circumstances that may require some sort of long term care.

Kore Cares has experience working with various LTC insurance providers, if you have any questions about what kind would be best for you, or what services yours covers, give us a call! We will work with your company to ensure your needs are met in any way we can. (605) 275-2344

Medicaid

Medicaid can cover a variety of LTC options. Each state has their own set of requirements needed to qualify. These include not exceeding income and asset levels set by your state’s Medicaid funding program.

Once you have qualified for Medicaid, a case worker from the state will assist you in choosing the right service setting (home care, assisted living, nursing home). If you qualify for home care services, you may be eligible for a variety of services including:

· Home nursing visits

· Assistance with ADL’s (bathing, dressing, using the bathroom, etc.)

· Housekeeping

· Companionship

· Respite care services

State Funded Programs

· Family Support 360

Provides support to children or adults with developmental disabilities. The program provides caregivers to those in need that wish to remain in their own home. Services provided can range from personal cares to respite care to relieve family caregivers that are the primary caregivers for the client.

· Respite Care or Caregiver Program

Through the Department of Human Services and upon qualification, the state of South Dakota can provide respite services to the following people:

    • Adult family members or other informal caregivers age 18 and older providing care to individuals 60 years of age and older;
    • Adult family members or other informal caregivers age 18 and older providing care to individuals of any age with Alzheimer's disease and related disorders;
    • Grandparents and other relatives (not parents) 55 years of age and older providing care to children under the age of 18; and
    • Grandparents and other relatives (not parents) 55 years of age and older providing care to adults age 18-59 with disabilities.

(List obtained from: http://dhs.sd.gov/ltss/caregiver.aspx)

Veterans Affairs

The VA offers long term support care to honorably discharged veterans who served for the required period of time. This criteria can be found here: http://vetaffairs.sd.gov/benefits/Federal/Healthcare.aspx

Spouses, widows, and widowers are also eligible for these benefits. Coverage for long term services can include personal cares, transportation, respite care, etc.

For more information, you can visit the South Dakota Department of Veterans Affairs website at: http://vetaffairs.sd.gov/aboutsddva/History.aspx

Private Pay

If you do not qualify for any funded programs, private pay is another option. Because this payment form is funded by the client themselves (or their loved ones), there are no limitations to the amount of services received. Anything from 1 hour every week to 24 hours a day is available. You are also not limited to only certain services and are eligible for any services you may need within your long term care agency’s scope of practice.

If you have any questions or need any more information on this subject, feel free to give us a call at (605) 275-2344.